Schizophrenia/psychosis Flashcards
Positive symptoms of schizophrenia
- Thought disorder
- Delusion
- Hallucination
- Disorganised behaviour
Negative symptoms of schizophrenia
- Anhedonia
- Apathy
- Blunting of affect
- Lack of volition
- Social withdrawal
- Avolition
- Poverty of speech
- Reduced attention
Name 4 motor/catatonic symptoms of schizophrenia
- Mutism
- Waxy flexibility - patients limbs can be moved to any position and they will hold it their for a prolonged period of time
- Posturing - voluntary assumption and maintenance of bizarre postures
- Negativism - unmotivated resistance to attempted movement or movement in the opposite direction
Name 4 categories of schizophrenia first rank symptoms with examples
Remember ABCD
-
Auditory hallucinations
- Running commentary
- 3rd person
- Thought echo
- Thought phenomenon
- Thought withdrawal
- Thought broadcast
- Though insertion
- Passivity (delusion of control)
- Made impulse (drives)
- Made volition (actions)
- Made affect (feelings)
- Somatic passivity (delusion of (lack of) control with somatic hallucinations
- Primary delusion
- Delusional perception/delusion of reference
Define psychosis and what symptoms it includes
Defined as a loss of touch with reality sx include
- Hallucinations
- Delusions
- Thought disorder
List organic causes of psychosis
- Delerium - caused by e.g. sepsis
- Drug induced - corticosteriods, stimulants, dopamine agonists (parkinsons drugs)
- Endocrine - cushings, hypo/perthyriod
- Neurological disorders - temporal lobe epilepsy, MS, huntingtons
- Systemic disease - lupus,
Diagnostic criteria for schizophrenia
- Sx for at least 28 days
- No organic cause
- Presence of first rank sx
Psychiatric disorders other than schizophrenia that can produce psychosis
- Mood disorder (mania/depression)
- Delusional disorder
- Acute/transient psychotic disorder
- Substance misuse
- Schizoaffective disorder
Necesarry physical exams and investigations when someone presents with psychosis
Physical
- BMI
- Neuro
Investigations
- Bloods
- LFT, TFT, FBC, glucose, lipids, cholesterol,
- Urine drug screen
- ECG
What is schizoaffective disorder
a mixture of first rank symptoms and mood symptoms
Good prognostic factors for schizophrenia
- Female
- Married
- Family history of affective disorder
- Acute onset
- Good Premobid personality
- Early treatment
- Prominent mood symptoms
- Good response to treatment
Poor prognostic features for schizophrenia
- Family history of schizophrenia
- High expressed emotion (more later)
- Substance misuse
- Prominent negative symptoms
- Early onset
- Lack of insight/non-compliance
- Opposite of good prognostic sx
What is paranoid schizophrenia
Schizophrenia dominated by persecutory delusions, hallucinations (often voices) and perceptual abnormalities
Difference between a pseudo and true hallucination
Generally patients believe true hallucinations are real whereas they can identify that pseudohallucinations are occuring in the absence of external stimuli
ergo voices that sound like you and me are true hallucinations whereas if they sound like they are coming from inside their head they are pseudo
